Thursday, October 14, 2010

Ask the Matriarch - communion for the homebound

Our question this week comes from a pastor who would like to offer communion to homebound members in a context where that hasn't been the tradition. She asks some great questions and gets some thorough and specific answers from the matriarchs. Perhaps you would like to share your thoughts too.

I am serving my first church as solo pastor and have been here several years. There is not a tradition of serving communion to homebound people in their homes here, and I'm not sure how to go about this or if it is important to introduce it. Other churches have deacons to fulfill this role, but we dont have those here, and so I'm kind of on my own.

I guess I'm uncertain about it, because in my previous setting as an associate, I took communion to people's homes sometimes and always found it a little awkward, both theologically and logisitically. Quite a few people just said "no" when I offered it, seeming to think it should happen at church or not at all.

If they said yes, I have a couple of those kits to take home communion in, but everything seems to be the wrong shape and size for the kind of bread we have, or to leak. And, the little plates and cuprs are so tippy and tiny, and I'm never sure where to put anything (there is often some kind of bedside table in these situations, but it's always covered with bottles or kleenex or something). Then, half the time the person is on a special diet, or has a hard time swallowing. Also, I guess I'm uncertain what exactly to say -- we are a rather "low" church but our communion liturgy is still pretty formal. I feel like the "communion at home" prayers and things I"ve read teeter between way too formal, and ridiculously informal.

Please be very specific. For example, when you're pouring the wine/juice out of the little plastic bottle into the little cup, do you say the words of institution then? Or do you get it all ready, and then present it? Do you just ease into it, sort of naturally as part of the conversation (I often pray this way), or do you set aside a time and offer it more ritualistically? If you are/have been homebound, would it have been meaningful to receive this sacrament and if so, how? When you take communion to homebound folks, what works? And, have you ever introduced the idea of communion in homes to a congregation that hasnt done it for a while -- or ever?

I find home communion to be one of the great privileges of ministry. My tradition requires that an elder or deacon accompany me, and we find it easy to recruit elders and deacons for this meaningful observance.

We make appointments in advance and certainly, some folks turn down the offer, but most accept, and it's always a really nice visit.

Here's how I handle the specifics: We visit for awhile, then I ask if it seems like time for communionl. I excuse myself to ready the elements while the elder/deacon continues the conversation with the person/people we're visiting. I typically say a short prayer that includes parts of the conversation we've been having. I then say the words of institution, and offer the elements. The elder/deacon offers a closing prayer.

I have introduced home communion with a church that had done little of it. It took time, but it was very well received. It's a very special opportunity for pastoral care and to extend the loving arms of the church. Perhaps it will feel that way to those with whom you serve!

I come from a tradition that not only offers home communion to the sick and homebound, but for whom it is expected. If one can’t come to church the church comes to them. We use ordained and trained lay folk (Lay Eucharistic Ministers) for this ministry. If I were serving a congregation for whom this ministry is a part of the life I’d begin with some teaching. I’d begin with the leadership team and share with them your experience of this ministry and why it is a powerful witness of the church in the world. I’d then invite a group of lay folk, from the leadership team and the general congregation, to learn about this ministry. After teaching the folks about it I’d invite a few people (if that would work in your tradition) to be trained as LEM’s (Lay Eucharistic Ministers). If using lay folk is too much too soon, then I’d focus the teaching on the importance of the ministry and do it myself for some time, and if it takes hold in the life of the congregation, then I’d invite some lay folk to participate, assuming that is allowed. I’d publish articles in the congregation newsletter and on the website. I’d preach about it and talk about it at every opportunity.

In terms of what I do: I’m very social when I make these visits. I spend a few minutes in friendly dialogue. (or as long as the person seems to desire – if they aren’t sick more time might be ok, if they are sick and in the hospital a short visit is important). Then I say, I brought communion from our Sunday morning (or weekday service), would you like to receive communion and a prayer for healing? I make it very simple. If I can’t spread out the bread and the wine on a table near the person I use a window ledge or a chair. Sometimes, depending on the condition of the person, I only offer a little piece of bread/wafer – which I bring in a special enclosed case called a pyx – these are like a little pill container, round with a hinged lid. They are nice because they fit in your pocket or purse.

When I intend to offer both bread and wine I use a kit, which can be made from small containers or purchased (not inexpensive) from places like Almy. These include a paten (plate), an enclosed cruet for the wine, a chalice, and sometimes tiny purificators (napkin) and corporal (placemat). Depending on the space available I lay it all out or not. At the very least I try to use the paten and the chalice. I used a simple service that includes an opening sentence: Blessed be the one holy and living God...(or something like that) and the person says, And blessed be God’s kingdom. Then I read a short phrase from scripture that describes God’s love and healing grace or hope. There are a few short prayer sentences for healing and then confession. After confession we say the Lord’s Prayer and then I offer communion. We conclude with either, a prayer for healing with a laying on of hands or a more simple prayer. You can find some options here: BCP ministry to the sick.

That said, I adapt all of this to tend to the condition and needs of the person. At a minimal I invite the person to pray with me the Lord’s Prayer and then offer communion and then offer a short prayer after.

I also create, one heavy paper/card stock, in large print, the entire service (from which I adapt) so that it can be easily used by anyone present.

That said, I have had people who find the idea of home communion to be uncomfortable. In these situations I just offer a prayer. Holy Eucharist is a gift, but it’s not required for God’s grace to fill their lives. Your presence and prayers can also be a sign of God’s love and grace. Blessings to you as you explore this powerful ministry and witness in the world.

You are right to identify the ‘previous practice’ of churches as important here – also I think the ecumenical mix of the congregation can make a difference. Some people are just more comfortable with the idea of home communion than others. I have even had good church folk who have looked at me as if I was offering the the Last Rites (which we don’t really have in my denomination) when all I said was ‘would you like communion at home?’ - so I think your instinct to take care is a good one. However since you asked for some suggestions, here are mine.

1.I try to take an elder of the church (or good friend of the house-bound person) with me – I think this helps it feel more like ‘we are sharing together’ rather than ‘I am giving you something’.

2.I always ask in advance ‘would you like communion at home?’ and ‘would you like x to come with me?’ rather than springing it on people.

3.I chat for a little while on arriving – sometimes sharing some of what happened at church on Sunday (eg which reading, what celebrations...) to establish that we are still one family of God together, even if we can’t all be in the building at the same time (the church building or their home).

4.I say something like ‘I’ll just set everything up..’ - I find a suitable table, make a space if necessary (& remember to put it all back afterwards!) and I am always touched to feel that this little bedside table/hospital trolley/ stool has become the table of the Lord – I sometimes make a comment to this effect. Setting up includes pouring the wine into the cup, putting the bread/wafer out. Sometimes I use a very formal little silver ‘mini chalice & patten’ other times I use a simple pottery cup & plate (depends on person and how high/low they are).

5.I ask ‘shall we start?’ so that people are clear this is the ‘liturgy’.

6.Whether I use a formal set service or something more informal depends on the person, again. But I always have something in my hands so that it feels a bit ‘more’ than a snack together. My personal preference is for the Presbyterian Church of Scotland ‘Common Order’ Fifth Order for Holy Communion ‘for use at home or in hospital’ - I sometimes trim things down depending on how the person seems (tired, restless, etc). Sometimes I use one of the readings form the Sunday worship either just gone or to come & I say where we’ve used it, to reinforce the sense of communion with the rest of the congregation.

7.Depending on how the person is (again!) I might put bread/wafer in their hands & hand them a cup – or dip bread/wafer in wine for them and place it in their mouth, or hold the cup to their lips... I’m not afraid to ask them in advance ‘what’s going to be the best way of doing this?’. I take the elements last so that I can consume what’s left (but that’s because I’m getting ‘higher’ in older age!).

8.I say a firm blessing so that we know to transition between liturgy & back into ‘conversation’. I chat as I ‘pack things away’ and restore the table to ‘normal’. If I’m offered tea or coffee, I personally prefer it now, after the ‘service’ rather than before.

I hope some of that is useful.

Over the years I have been very touched by some people who would have a little table ready for me – complete with little vase of flowers, possibly a candle, even a little white table cloth – I love these signs that they have got ready for the coming of God into their home. Other times I have rejoived at Jesus’ presence in the midst of all the mess and clutter – among the pills, letters, and yogurt pots.

Be bold – and God bless you.

Ruth

And Muthah+ offers this:

Taking Communion is always awkward because we are so used to it being in church. But I think of it as just one more way of bringing healing into an environment of ill-health. I would suggest you write a short service that seems right for you. Sometimes our prayerbooks or hymnals get in the way for what you want to highlight. Print it out in a size that can fit in you communion kit. I find the little plastic cups for hospital calling to be wise so that they can be thrown away following the service. This where “fish food”—pressed hosts for bread, any reason to call them bread. I have a pyx in my communion kit just the right size for hosts—but some of the smaller kits do not have them. Find a little box that will provide the right size. I refuse to buy an oil stock because they are so expensive. I have found that a pill dispenser with some cotton and blessed olive oil in it will provide the oil for healing that many find helpful.

If the family is present and they would find a celebration convenient, I will take a roll from the patient’s lunch tray and I carry small single serving bottles of wine and celebrate the whole Eucharistic service for them. If you are taking elements from your congregational service, make sure that those receiving them are reminded of the prayers of the faithful who sent you there.

When I first started in ministry I found that people refused the sacrament but I finally realized that many refused it because they had never received that way before. Talk to them about it and then move into it informally if they are willing. As you experience it more, you will be able to discern when to be formal and when to make it simple. That comes with practice. Most of all, let your people see the Christ in you as you minister to them at home or in hospital.

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Thank you to our wonderful Matriarchs for such great responses! What about the rest of you? Please share your thoughts and experiences in the comment section. And, as always, if you have a question you'd like the matriarchs to respond to, please email us at askthematriarch[at]gmail[dot]com.

12 comments:

I too have found this awkward at times - and it is very much a tradition at my parish and within the Lutheran denomination. However, I often think part of my call is to experience those brief moments of awkwardness when the result could be live-giving and grace-filled for all involved.

I usually ask if they would like to receive before hand. I bring a small service book, and my "To-Go Box" as I call it. Wooden box with pyx for wafers, small wine bottle with screw top and 4 small glasses. I set it all up - usually in my lap - on top of the box. Pour two small glasses and set out two wafers - which takes some logistics practice. I also ask if we're ready to begin, so that there is a formal separation btw. our conversations and the liturgy of the eucharist. I'll say a short prayer, read a lesson, offer the words of institution, communion the other person, commune myself and then offer a prayer and a blessing.

My congregation has a strong tradition of taking communion to the homebound. Two of the elders spend one Thursday every month going from home to home to offer conversation, prayer and communion which is gratefully received.

When it comes to folks in the hospital I typically take my traveling communion kit (which is similar to Erin's and can be purchased from Cokesbury) and after visiting for a while ask if they would like to receive communion. Because the kit is so small I can easily set up either on their tray table or bedside table when we are ready to begin. I treat setting the table as part of the communion service so it doesn't seem an awkward break in the visit. I then read scripture, pray and say the words of institution before serving the patient and any other visitors and offering a benediction. Sometimes the patient's roommate asks to take part as well. I love when that happens.

I have some members who love to be anointed when they are sick and some who aren't used to that practice. One family became very angry with me early in my ministry because their father thought I was administering Last Rites. We don't do Last Rites, but he was raised Catholic and, while I thought I had made clear that I was anointing for healing, he misunderstood. I am VERY careful now about that particular practice.

Most of my home or hospital visits include communion. At some point in the conversation, usually towards the end, I start pulling out my communion kit and setting up. (My tip for those little kits is to have a rubber band around the pyx or wafer container. I hate how this looks but it is better than opening the kit to find the lid has slide off again and wafers fly everywhere including at the feet of the pious woman you are visiting.)

I always bring my hymnal on visits so I offer to sing a hymn as a way to transition from conversation to communion. Since we are a liturgical church so I start with The Lord be with you. Sometimes they respond sometimes they don't and I just move on. Then I say the Words of Institution and ask them to pray the Lord's Prayer with me. Then I distribute the bread and wine. After a moment I give the post communion blessing "May the body and blood of our Lord Jesus Christ strengthen you and keep you in his grace."

One of the ways I describe home communion (using the already consecrated bread and wine) to people I visit and to the congregation is to think of it as extending the altar rail. In their home, we are sharing in the same communion as those who worshipped on Sunday--when the elements were blessed--but at the far end of the rail! This makes sense to a lot of people and seems to help them feel less intimidated by the idea.

I don't have anything to add- lots of good suggestions --other than I've been doing this for 25 years and I really like the idea of making it a practice of bringing a deacon or another church member along.

I like this because it counteracts the idea of this being "private" communion and making it more of a community event. I also like it because for 25 years this has always been considered MY job, MY responsibility and people are always the most critical that I get to the shuts often enough. Make it the responsibility of the whole church.

MomPriest and I come from the same tradition, and quite a bit of what we do is the same. If the ill person is a relatively new member of the Episcopal Church they sometimes don't feel comfortable, and if it is not desired, I simply make a pastoral visit and pray for the person, frequently anointing them with oil as I pray for God's presence and healing. i do initiate a conversation about "bringing the parish to them" and explain that whenever they would like, I will bring them communion. It is a healing moment as well as a teaching time. God bless you, and go for it!

i am in a rural area, where it is highly expected the pastor be the one to bring the elements for a home/hospital/shut-in visit.

i have a portable HC set that i keep in my vehicle, and use plastic cups for ease... no chalice, just patent for wafers.

i visit with folks quite awhile, tell them i brought HC, then set up, usually on my lap... i put the patent/wafers on top of the kit's box, with the glasses filled w/wine... (if it's a 1 on 1 visit, or visiting a couple; if it's a larger group, i stand, and use whatever hard surface is available... i mean only so much wine fits on a lap)

i set up; speak the words of institution; commune; we visit some more; then i ask if they have anything special they'd like to pray for and i offer prayer.

i am very laid back in my visits... using a book or a formal liturgy or pre-printed prayers just isn't my thing in those situations.

trust your gutt. and i do like mompriest's suggestion of educating your leaders on "whys" of doing home communion..

From my hospital chaplain days: One meaningful option for people who cannot swallow is to put a splash of wine in a cup (or on a gauze pad) and let the communicant touch it (or their finger) to their tongue. As to specifics, I generally take reserve sacrament (already consecrated).

Since I am a hospital chaplain now, I can see how much the sacraments mean to those who are too ill to attend services. The Catholic patients in our hospital are well served by lay eucharistic ministers, but the Protestant denominations are not.

I have presided twice at the hospital, and both times it included family members. I think that while people may feel awkward, they also later talk about how much it meant to celebrate together. So it makes me less shy about offering to administer communion.

At my church, a "stumbling block" for former pastors was always that they were perceived as not visiting the home bound enough. I think some sort of schedule for this activity would help this perception. The pastors have always offered communion. These days, we have some people who take the little box of consecrated elements right from the altar, as soon as they have been served, and leave the building to go visit the shut-ins. I don't know how many of the people in the pews actually know what is happening, but I like the symbolism of that and I like it that the pastor isn't the only one doing this work.

Two years ago, I took my aunt to visit her sister (also my aunt) in a nursing home. The pastor just happened to come in for his monthly visit at the same time. He included the two of us in the communion that he served to my aunt. I found it very meaningful, especially since I can't easily get to church when I am visiting there. He wasn't serving communion to strangers, as he is also my mom's pastor.